The study of facial aesthetics is not new. Philosophers and artists have struggled for centuries to identify the concrete structural relationships that create an aesthetically pleasing face. Relationships and proportions for pleasing facial contours are well understood, but only in general terms.
Facial attractiveness, while innately recognizable by lay people and artists, has in the past been difficult to quantify. However, it is understood that facial attractiveness can be defined by at least two main facial characteristics, namely quality of facial parts and position of facial parts. The quality of the eyes, skin, the hair, and lips alter the perception of what is beautiful. Cosmetology and the fashion industry (and to a certain extent medicine by dermatology and chemical skin peels to improve the color, tone, smoothness of the skin) are founded upon improving these qualities.
The position of the facial parts also greatly impacts the perception of beauty. The spatial position of the cheekbones, orbital rims, nose, lips, and chin represents position of parts. Surgeons and orthodontists change the position of facial parts with treatment.
In the past, treatment has focused exclusively on bite correction and not on associated facial changes. Historically, treating doctors have relied on model analysis and cephalometric analysis to treatment plan occlusal changes. It has been assumed that correction of model and cephalometric abnormalities would lead to facial balance.
Experience reveals that model diagnosis is incomplete. Model examination identifies inteijaw occlusal discrepancies but does not indicate which jaw is abnormally placed. Because of this, model-based bite correction can create facial decline. A study of US orthodontists published in 1993 revealed that 54.9 percent of all orthodontic treatment decisions were based on model examination without other diagnostic modalities. Multiple orthodontic studies have shown facial decline as a result of bite correction based on model analysis. This indicates the need for a reliable facial examination tool such as the STCA.
Cephalometrics emerged in an attempt to quantify the position of parts and thus define facial aesthetics, and has become very well established. The traditional cephalometric method is objective but suffers from measurement of the wrong part of the human anatomy. While facial bones are not normally seen as the essence of beauty, this is what cephalometrics has focused upon-the study of facial bones and their relationship to each other. Unfortunately, errors in diagnosis and treatment planning occur by using osseous cephalometric norms to guide facial outcomes.
Indeed, treatment based on cephalometric hard tissue diagnosis may create undesirable facial change depending on which method of cephalometric analysis is used. Multiple studies have concluded that no correlation exists between traditionally osseous cephalometric treatment planning and facial balance and beauty. Moreover, when different cephalometric analyses are used for skeletal anomalies, as shown in FIG. 1 (note the excess incisor exposure, interlabial gap, and class II profile) and FIG. 2 (note lip redundancy, absence of incisor exposure or interlabial gap, and Class III profile secondary to overclosure of the mandible) respectively, different diagnoses are indicated. Some of these traditional cephalometric analyses are set forth in Tables I and II, resulting in a different diagnosis, different treatment plan, and therefore different outcomes (see indicated treatment movements at bottom of (Tables I and II).
To assure that occlusal treatment favorably alters the position of facial parts, there accordingly remains a strong need for an objective method of cephalometric analysis. This analysis should lead to a complete and full understanding of the various positions and relationships of the various structures of the face and head. Furthermore, information from this analysis should provide a method of cephalometric treatment planning of the soft tissues as well as bite correction.